# An Optimizer-Simulator for Phonosurgery

> **NIH NIH R01** · UT SOUTHWESTERN MEDICAL CENTER · 2020 · $387,730

## Abstract

PROJECT SUMMARY/ABSTRACT
The surgical treatment of voice disorders has been largely developed through a trial-and-error approach. A
newly conceived procedure is tried on a few patients and is considered successful if those patients have good
outcomes. A more rational approach to surgical design and planning would reduce undesirable outcomes and
shorten the time to develop successful surgical techniques. In principle, computational voice simulation can
help surgeons predict how changes to vocal fold anatomy lead to changes in the voice. However, current
simulation approaches are limited. Most generate only a single voice output based on a fixed vocal fold
anatomy. What would be more useful to surgeons is a way to identify the vocal fold anatomy required to
produce a desired voice outcome. The objective of this proposal for translational research is to develop a
computational tool for surgeons to predict the vocal fold anatomy required to meet a particular vocal demand.
The proposed Phonosurgery Optimizer-Simulator (PHONOS) software performs several hundred rounds of
voice simulations, with each round producing vocal outputs closer to the desired vocal target than the previous
round. In the end, the surgeon will have a set of vocal fold anatomies that produce voice that satisfies the
patient's vocal priorities. This will (1) enable a surgeon to compare different surgical options to determine which
better meets the patient's vocal priorities and (2) inspire the design of new phonosurgical procedures based on
the suggested vocal fold anatomies.
 Three specific aims are proposed. In Aim 1, a Vocal Priority Questionnaire will be developed and
validated. This instrument will ask the patients to rate the importance of pitch, loudness, vocal endurance, and
vocal clarity in their daily activities. The vocal attributes considered to be more important could then be more
heavily favored or weighted during computation. In Aim 2, the NCVS Voice Simulator, which forms the core of
PHONOS, will be adapted for use by surgeons. A series of graphical user interfaces will replace command line
inputs to allow intuitive manipulation of vocal fold morphologic parameters in three dimensions. In Aim 3, the
simulator will be integrated with an optimization engine to enable efficient searches for vocal fold anatomies
that produce the target vocal outcome. The optimization scheme makes it possible to preferentially weigh vocal
attributes considered to be more important by the patient.
 The software thus developed will enable surgeons to evaluate the relative merits of existing surgical
options, influence surgical decision making based on patient preference, and stimulate the design of novel
surgeries for vocal folds. This work will shift the paradigm of phonosurgery from a focus on restoring normal
vocal fold anatomy to improving vocal function based on patient priorities, thereby transforming decision
making in the surgical treatment of voice disorders.

## Key facts

- **NIH application ID:** 9999302
- **Project number:** 5R01DC014538-05
- **Recipient organization:** UT SOUTHWESTERN MEDICAL CENTER
- **Principal Investigator:** I-Fan Theodore Mau
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $387,730
- **Award type:** 5
- **Project period:** 2016-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9999302

## Citation

> US National Institutes of Health, RePORTER application 9999302, An Optimizer-Simulator for Phonosurgery (5R01DC014538-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9999302. Licensed CC0.

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